Claims rates for E/M modifiers 57, 24 hold steady, but denials inch up

Why This Topic Matters

Modifier utilization and denials can affect billing accuracy, compliance monitoring, and revenue-cycle performance. Understanding recent Medicare trend patterns helps coders and reimbursement teams evaluate whether their own claims activity is consistent with broader utilization and denial experience.

Article Sections

1. Modifier utilization trends

   Overview of recent Medicare claims volume trends for the two modifiers and how those trends compare across multiple years.

2. Most common associated E/M services

   Discussion of the E/M service types most frequently reported with each modifier and their relative share of claims.

3. Denial rates and specialty patterns

   Summary of overall denial trends and the specialties with the highest or lowest denial patterns in the data.

4. Modifier 24 utilization, top 10 specialties, 2024, with denial rates

   A data display section presenting specialty-level utilization and denial information for one modifier in 2024.

5. Modifier 57 utilization, top 10 specialties, 2024, with denial rates

   A data display section presenting specialty-level utilization and denial information for the other modifier in 2024.